Active NPI
Martha Jane Vandyck, DPH
- Pharmacist
- Germantown, TN
National Provider Identifier
1467720235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5890
- Practice address
- 9325 Poplar Ave
Germantown, TN 38138-7906 - Phone
- (901) 309-1609
- Fax
- (901) 309-1067
- NPI assigned
- Dec 8, 2011
- Last updated
- Dec 8, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5890 | TN | Primary |
Addresses
Primary practice location
9325 Poplar Ave
Germantown, TN 38138-7906
Mailing address
9325 Poplar Ave
Germantown, TN 38138-7906
Phone (901) 309-1609
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5890 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323302400000",
"number": "1467720235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9325 POPLAR AVE",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381387906",
"telephone_number": "901-309-1609",
"fax_number": "901-309-1067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9325 POPLAR AVE",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381387906",
"telephone_number": "901-309-1609",
"fax_number": "901-309-1067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDYCK",
"first_name": "MARTHA",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "DPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-08",
"last_updated": "2011-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "5890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, TN
- Jennifer Lou Valli, PHD
- Ettienne R. Van Zyl, D.D.S.
- Virginia Ekaterina Vanausdall, OTR/L
- Ari M. Vanderwalde, M.D.
- Noam A Vanderwalde, MD
- Anne Katherine Vanlandingham, MPT
- Vascular and Vein Institute of the South, PLLC
- Vascular and Vein Institute of the South, PLLC
- Michelle Vasireddy, PA-C
- Catherine Alexander Vaughan, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.